Gluten-Free Diet – Who Is It For?

The Popularity of the Gluten-Free Diet

The gluten-free product market is one of the fastest-growing sectors in the food industry. More and more restaurants and cafés are meeting customer expectations by offering gluten-free versions of their dishes.

But what is behind the growing popularity of the gluten-free diet? Is it a trend, an attempt to live a healthier lifestyle, or the result of a rise in gluten-related diseases?

One American study conducted a survey on gluten-free diet use. Thirty-five percent of respondents cited “no specific reason” for adopting the diet. Over a quarter considered it a “healthier version” of a regular diet. Nearly 20% followed it to “improve gastrointestinal function” (1).

Gluten-Free Diet – Who Should Follow It?

A gluten-free diet is primarily recommended for individuals with gluten-related disorders (e.g., celiac disease, non-celiac gluten sensitivity, wheat allergy). In certain other conditions, gluten exclusion or reduction may also offer potential health benefits. However, dietary changes in these cases should be considered individually.

Gluten-Free Diet for People with Celiac Disease, Allergy, and Sensitivity

Celiac disease is an autoimmune condition in which gluten causes damage to the small intestinal villi. These villi increase the intestinal surface area and play a crucial role in nutrient absorption.

By eliminating gluten, nutrient absorption improves, the villi regenerate, and clinical symptoms diminish or disappear. In this case, a strict lifelong gluten-free diet is the only effective treatment.

Food allergies and non-celiac gluten sensitivity are more common than celiac disease. In these cases, a tailored diet can reduce symptoms such as bloating, diarrhea, constipation, nausea, vomiting, or abdominal pain — and sometimes even eliminate them entirely. Options may include a strict gluten-free diet, a low-gluten diet, or avoidance of a specific gluten-containing grain.

The severity of symptoms and their underlying causes vary. As such, the length and strictness of the diet should be individualized.

Gluten-Free Diet for Malabsorption Syndromes

Patients recovering from chemotherapy, long-term antibiotic use, or parasitic infections may suffer from malabsorption syndromes. A temporary gluten-free diet may alleviate symptoms like diarrhea and vomiting and help prevent excessive weight loss.

Gluten-Free Diet in Autoimmune Diseases

People with autoimmune diseases other than celiac disease — such as Hashimoto’s thyroiditis, type 1 diabetes, rheumatoid arthritis (RA), or multiple sclerosis (MS) — may also benefit from a gluten-free diet.

These patients are at increased risk of developing celiac disease, as autoimmune conditions often co-occur. Statistics show that 1 in 62 people with Hashimoto’s disease also has celiac disease (2). Therefore, testing for celiac disease is advised before beginning a gluten-free diet.

Multiple sclerosis is an inflammatory autoimmune disease where the immune system attacks the myelin sheath covering neurons in the brain. While some studies suggest benefits of a gluten-free diet in MS, the evidence remains inconclusive. Dietary changes should be considered on a case-by-case basis.

Importantly, there is currently no definitive evidence supporting the use of a gluten-free diet in autoimmune diseases not accompanied by celiac disease.

Gluten-Free Diet in IBS

Irritable bowel syndrome (IBS) is a chronic condition characterized by gastrointestinal symptoms such as cramping, abdominal pain, bloating, gas, diarrhea, and constipation.

Research shows that about 30% of IBS patients also suffer from non-celiac gluten sensitivity. Therefore, some IBS patients may benefit from reducing gluten intake.

However, recent studies suggest that other components in grains — such as fructooligosaccharides — may be the actual triggers. Hence, the primary treatment for IBS is the low-FODMAP diet, which eliminates fermentable oligo-, di-, monosaccharides, and polyols (3). These compounds are also found in wheat and rye products.

Before altering the diet, patients should rule out small intestinal bacterial overgrowth (SIBO), which can be diagnosed using a breath test.

Gluten-Free Diet and Neurological Disorders

There is growing scientific discussion about the potential link between celiac disease and neurological or neurodevelopmental disorders such as ADHD, autism spectrum disorders, migraines, seizure disorders, and motor coordination issues.

However, the available studies are inconsistent. Many suggest increased intestinal permeability in these conditions, likely due to inflammation, infections, food intolerances, or dysbiosis. Gluten has also been suspected of triggering inflammatory responses.

Despite these theories, there is currently insufficient evidence to recommend a gluten-free diet as a routine treatment for neurological disorders.

Does a Gluten-Free Diet Promote Weight Loss?

Eliminating gluten does not automatically lead to weight loss. Although many people adopt gluten-free diets to shed extra pounds, simply excluding gluten will not guarantee weight reduction. Achieving this requires a caloric deficit and physical activity.

Gluten-free products often contain more saturated fat, overall fat, and sugar. As a result, they may be more calorie-dense, potentially increasing total energy intake. Additionally, processed gluten-free products are typically lower in vitamins and minerals.

Therefore, if not properly planned, a gluten-free diet may actually lead to nutritional deficiencies or even weight gain.

Gluten-Free Diet for Athletes

Athletes are increasingly adopting gluten-free diets in hopes of improving performance. However, current research does not support the idea that a gluten-free diet enhances athletic performance or provides health benefits — unless the athlete has a gluten-related condition.

Gluten-Free Diet – Who Is It For?

The main indication for a gluten-free diet is the presence of gluten-related disorders. Celiac disease is a strict and lifelong indication for eliminating gluten, as the diet improves nutrient absorption and reduces symptoms.

A gluten-limited diet may benefit people with malabsorption issues, some IBS patients, and individuals with autoimmune diseases that increase the risk of celiac disease. However, such dietary changes should always be individualized and consulted with a physician.

A gluten-free diet does not guarantee weight loss, nor has it been proven to improve physical performance. As a form of elimination diet, if poorly balanced, it may lead to deficiencies.

Remember: a gluten-free diet is not recommended for healthy individuals. If you’re considering going gluten-free, consult a dietitian or healthcare professional first.